A meta-analysis on the association between bladder cancer and occupation

Authors: Reulen, Raoul¹; Kellen, Eliane²; Buntinx, Frank³; Brinkman, Maree⁴; Zeegers, Maurice⁵

Source: Scandinavian Journal of Urology and Nephrology, Volume 42, Supplement 218, September 2008 , pp. 64-78(15)

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Abstract:

To date, many epidemiological studies have been conducted to examine the association between occupation and bladder cancer incidence. However, results from these studies often have been inconsistent, and significant associations have rarely been found, possibly owing to the lack of adequate statistical power in these studies. This meta-analysis summarizes the relevant literature regarding occupation and bladder cancer incidence to increase the statistical power to detect associations. The Medline and Embase databases were searched to retrieve epidemiological studies published up until May 2008. Individual risk estimates for subjects with an employment history in the occupation of interest were extracted from each included publication. For each occupation, a summary relative risk (SRR) was calculated by means of a random effects model. Significantly increased risks with an SRR greater than 1.20 were identified for miners [SRR=1.31, 95% confidence interval (CI) 1.09-1.57], bus drivers (SRR=1.29, 95% CI 1.08-1.53), rubber workers (SRR=1.29, 95% CI 1.06-1.58), motor mechanics (SRR=1.27, 95% CI 1.10-1.46), leather workers (SRR=1.27, 95% CI 1.07-1.49), blacksmiths (SRR=1.27, 95% CI 1.02-1.58), machine setters (SRR=1.24, 95% CI 1.09-1.42), hairdressers (SRR=1.23, 95% CI 1.11-1.37) and mechanics (SRR=1.21, 95% CI 1.12-1.31). In conclusion, the studies reviewed provide consistent support for a small but significant increased risk of bladder cancer among workers in these nine occupations. Although the relative risk of bladder cancer associated with these occupations is small, the public health impact may be significant, considering the substantial number of people who were and are employed in these occupations.

Keywords: Bladder cancer; epidemiology; meta-analysis; occupation

Document Type: Research article

DOI: 10.1080/03008880802325192

Affiliations: 1: Centre for Childhood Cancer Survivor Studies, 2: Department of General Practice, Catholic University of Leuven, Leuven, Belgium 3: Department of General Practice, Catholic University of Leuven, Leuven, Belgium,Department of General Practice, and Department of Complex Genetics, Nutrition and Toxicology Research Institute, Maastricht University, Maastricht, The Netherlands 4: Department of General Practice, Catholic University of Leuven, Leuven, Belgium,Cancer Epidemiology Centre, The Cancer Council, Victoria, Australia 5: Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK,Department of Complex Genetics, Nutrition and Toxicology Research Institute, University of Maastricht, The Netherlands